How ASCs Can Manage Expenses and Physicians

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When it comes to managing ambulatory surgery centers, the two areas that require the most management are expenses and the ASC's physicians. Nap Gary, COO of Regent Surgical Health, moderated a discussion with Al McNair, MD, and Steven Schuleman, MD, at the 18th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 27 to cover different ways ASC leaders and administrators can handle those two areas efficiently.

Managing expenses
Dr. Schuleman, an anesthesiologist and part-owner of the Texas Center for Special Surgery in San Antonio, said he had little experience when it came to managing expenses before he entered the ASC industry, but he realized how crucial it was to the viability of an ASC. Case costing is one of the most important things a center can do because mining that data shows what the most expensive implants are, what a specific procedure costs per operating room minute and other areas where an ASC may or may not be profitable, he said.

Dr. McNair, a gastroenterologist, added that the two biggest areas of managing expenses are supplies and salaries. Dealing with compensation issues, such as creating a 72-hour two-week pay period or limiting overtime, can be a touchy subject, but ASCs must be willing to confront their staff. "Don't overlook the trust of your staff on how to improve care and cut salary costs," Dr. McNair said. "They know where you can save, and they can come up with solutions, and you should reward them for that."

He also added that ASCs should cross train staff to work anywhere in the ASC, and in some cases, such as the upcoming ICD-10 transition, outsourcing tasks could be a solution to minimize costs. "Your staff has to be pretty bright to stay on top of [ICD codes], and sometimes outsourcing it to an agency where that's all they do may make sense when it comes to maintaining profitability," Dr. McNair said.

Managing physicians
Dealing with and managing physicians is a more sensitive issue because an ASC does not want to disengage or upset anyone within the organization, Dr. McNair said. When it comes to managing physicians, he said there are two ways to look at it and present things to physicians: What can ASCs do for physicians, and what do physicians have to do for centers.

To make things most palatable for physicians, ASCs should keep several things in mind, such as convenient scheduling, good turnarounds on different procedures and making sure the quality of staff is good enough for the physicians. Additionally, Dr. McNair said it is beneficial to conduct reviews every quarter with physicians to record the physicians' satisfaction, if the center is meeting their needs, if the staff is up to par, if the equipment is adequate and to make sure there are no scheduling conflicts.

Related Articles on ASC Management:

9 Key Issues Facing Great ASC Administrators
Driving ASC Performance Through Effective Financial Management
5 Best Practices for Revenue Capture at Endoscopy ASCs

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